{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T21:01:33Z","timestamp":1769202093710,"version":"3.49.0"},"reference-count":12,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>The Tokyo 2020 Olympic and Paralympic Games (Games) were held during the height of the coronavirus disease 2019 (COVID-19) pandemic. To detect people infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) early enough to contain the spread and to facilitate the timely arrival of athletes at their game venues, all participating athletes staying in the Olympic Village (up to 14,000) were screened daily for the infection. Toward this aim, a two-step strategy was adopted comprising screening of self-collected saliva samples using a chemiluminescence enzyme immunoassay, followed by confirmatory testing using polymerase chain reaction. The testing system was integrated with an information management system covering all steps. To ensure the accuracy of the test results, rigorous quality assurance measures and monitoring of performance\/specimen quality were implemented. A chronological chart analysis was implemented to monitor the holistic process and to give feedback to improve the sampling. Nearly all test results for 418,506 saliva samples were reported within 12 hours of sample collection, achieving the target mean turnaround time of 150 minutes for confirmatory testing. As a result, athlete activity and performance for the Games were ensured. The chronological chart confirmed that no athletes were withdrawn due to a false-positive result, and no infection clusters were identified among the athletes in the Olympic Village. In conclusion, continuous quality improvement as part of the two-step strategy for mass screening for COVID-19 contributed to the success of the Games during the pandemic. The quality practice, systems, and workflows described here may offer a model for future mass-gathering sporting events during similar major infectious disease epidemics.<\/jats:p>","DOI":"10.1371\/journal.pone.0304747","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T17:21:54Z","timestamp":1727371314000},"page":"e0304747","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Continuous quality improvement with a two-step strategy effective for mass SARS-CoV-2 screening at the Tokyo 2020 Olympic and Paralympic Games"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5343-6751","authenticated-orcid":true,"given":"Hayato","family":"Miyachi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4075-3141","authenticated-orcid":true,"given":"Satomi","family":"Asai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rika","family":"Kuroki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuya","family":"Omi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiaki","family":"Ikenoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Shimada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"pone.0304747.ref001","unstructured":"World Health Organization (2020). Rolling updates on coronavirus disease (COVID-19). Available from: https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/events-as-they-happen (Accessed on 27 Nov 2023)."},{"key":"pone.0304747.ref002","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1136\/bjsports-2022-105691","article-title":"Contributions of the Tokyo 2020 Infectious Diseases Control Centre in curbing SARS-CoV-2 spread during the Olympic and Paralympic Games","volume":"57","author":"S Shimada","year":"2023","journal-title":"Br J Sports Med"},{"key":"pone.0304747.ref003","doi-asserted-by":"crossref","first-page":"102127","DOI":"10.1016\/j.tmaid.2021.102127","article-title":"Logistic advantage of two-step screening strategy for SARS-CoV-2 at airport quarantine","volume":"43","author":"I Yokota","year":"2021","journal-title":"Travel Med Infect Dis"},{"issue":"3","key":"pone.0304747.ref004","doi-asserted-by":"crossref","first-page":"e559","DOI":"10.1093\/cid\/ciaa1388","article-title":"Mass Screening of Asymptomatic Persons for Severe Acute Respiratory Syndrome Coronavirus 2 Using Saliva","volume":"273","author":"I Yokota","year":"2021","journal-title":"Clin Infect Dis"},{"key":"pone.0304747.ref005","doi-asserted-by":"crossref","first-page":"e397","DOI":"10.1016\/S2666-5247(21)00092-6","article-title":"A novel strategy for SARS-CoV-2 mass screening with quantitative antigen testing of saliva: a diagnostic accuracy study","volume":"8","author":"I Yokota","year":"2021","journal-title":"Lancet Microbe"},{"key":"pone.0304747.ref006","unstructured":"International Organization for Standardization. ISO\/TS 5798; 2022. In vitro diagnostic test systems\u2013Requirements and recommendations for detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by nucleic acid amplification methods. Available from: https:\/\/www.iso.org\/standard\/81712.html (Accessed on 27 Nov 2023)."},{"key":"pone.0304747.ref007","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.ijid.2021.11.022","article-title":"Nationwide external quality assessment of SARS-CoV-2 nucleic acid amplification tests in Japan","volume":"115","author":"S Asai","year":"2022","journal-title":"Int J Infect Dis"},{"key":"pone.0304747.ref008","unstructured":"ISO 15189:2022. Medical laboratories\u2014Requirements for quality and competence. https:\/\/www.iso.org\/standard\/76677.html"},{"key":"pone.0304747.ref009","unstructured":"Burke P. Tokyo 2020 did not result in increased COVID-19 cases in Japan IOC claims citing study. 31 Dec 2021. https:\/\/www.insidethegames.biz\/articles\/1117299\/tokyo-2020-covid-cases-contained-ioc"},{"key":"pone.0304747.ref010","first-page":"9","article-title":"Large-scale international volleyball competition in \"bubble\" under the COVID-19 pandemic","volume":"202227","author":"T Nishino","journal-title":"Asia Pac J Sports Med Arthrosc Rehabil Technol"},{"key":"pone.0304747.ref011","doi-asserted-by":"crossref","unstructured":"Caniza H Forriol F Pangrazio O et al. Safety of international professional sports competitions during the COVID-19 pandemic: the association football experience. Sports Med. 202353:765\u2013768. doi: 10.1007\/s40279-022-01763-3. Epub 2022 Sep 27. 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